The definitive source for scientific knowledge needed to guide optimal patient care, management, and biomedical discovery are the biomedical journals and conference proceedings. Starting more than two decades ago, the rate of publication in all medical specialties and research fields has become so high that it is virtually impossible for even the most dedicated professionals to keep up with the thousands of articles published in each field every year. The problem becomes more pressing when one has to care for multiple patients with limited time to spend per patient and perform literature searches under unkindly deadlines.
Ways to address this problem that have been explored so far include: reviews and textbooks, guidelines, and various services that abstract the state-of-the-art knowledge, as well as automatic filters to select the best papers (according to methodological criteria) in broad content categories.
Unfortunately, all these methods have drawbacks: textbooks are typically out of date to a significant degree by the time they are printed; reviews cannot possibly cover all conceivable patient cases, nor is it agreeable in the scientific community how to conduct them in unbiased and non-distorting ways; guidelines address a narrow range of clinical case types, are very labor intensive to produce, and quickly become outdated; on-line and printed abstraction services typically rely on the authority of their editorial boards and represent a tradeoff between authoritative reviews/guidelines and speedier knowledge dissemination in focused areas; finally, automatic filters so far have relied on ad-hoc quality gold standards, labor-intensive construction, and outdated retrieval technologies.
At the same time studies show that 50% of the 100 million U.S. health consumers who are Internet users routinely search for answers to their health-related questions on the web. There are in excess of 10,000 health-related web sites. Very few of them are factually correct, up-to-date, or complete (with respect to some subject). Many sites push some commercial or other agenda that may lead the public astray.
The principal methods developed so far for helping consumers identify high-quality health-related web sites are: (a) the user applies manually for each site one of more than 100 available quality assessment protocols, and (b) citation-related metrics such as PageRank™. Both of these methods have weaknesses: The vast majority of quality assessment protocols have not been validated, and their application is laborious, time consuming, and beyond the abilities of many users, paradoxically including, in particular, those with low educational background, limited time, or who are under health-related discomfort. It is not known how well citation-related metrics filter out the sites that promote unscientific, suboptimal, dangerous and unnecessarily expensive medical modalities. Plenty of anecdotal evidence suggests that Web-related citations do not provide a satisfactory solution to this problem.